Provider Demographics
NPI:1548025240
Name:TIMME, SIERRA ELISABETH ANN
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:ELISABETH ANN
Last Name:TIMME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2653 ARLINGTON DR APT 102
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-3627
Mailing Address - Country:US
Mailing Address - Phone:910-638-9490
Mailing Address - Fax:
Practice Address - Street 1:14000 CROWN CT WOODBRIDGE
Practice Address - Street 2:201
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193
Practice Address - Country:US
Practice Address - Phone:703-499-8787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist